Press Down the Qi Pill

Two drugs, forty-nine pieces of each, which is a ritual number rather than a measured one. Black pepper is the warming, moving half and the scorpion is there because the section reads the distension as qi forcing upward out of a depleted spleen and stomach. Radish seed is added when the belly is big, and that is the most rational ingredient in the leaf — it is a genuine carminative. **Contains whole scorpion (全蝎) in a formula given to a child, and the text gives no dose by weight here — the drugs are counted out as forty-nine pieces each and the pills are counted out as five to seven, or ten to twenty, with no reference to the child's size. This must not be prepared.** Dried scorpion is the standard material and its venom is a neurotoxin; the content of a given scorpion cannot be known, so the active dose in a millet-sized pill is unmeasurable. Forty-nine scorpions divided into small pills, five of which go into a baby, is not a quantity anyone can defend. **A qi-moving pill given into an obstruction is dangerous**, and distension is the presentation an obstruction takes. A child whose belly is distended needs the surgical causes excluded first — obstruction, intussusception, a perforating appendicitis — and green bilious vomiting, blood in the stool or a rigid tender abdomen means that exclusion cannot wait. Where the belly is distended without those signs, the common causes are constipation, aerophagia, and in a thin child with a protuberant abdomen, malnutrition, coeliac disease or a chronic parasite load. None of them is treated by pepper and scorpion. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.